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WEB EXCLUSIVE | DERRICK Z. JACKSON

The diabetes explosion

Being a couch potato may be as deadly as smoking a cigarette. It is National Diabetes Awareness Month and the latest statistics should turn awareness into alarm.

In the United States, diabetes is the sixth leading official cause of death, killing 73,000 people a year, and contributes to 224,000 deaths a year, according to Centers for Disease Control. But as obesity continues to explode in America, diabetes may very well pass smoking as a preventable killer. A new report by the Yale Schools of Public Health predicts that at current rates of increase, the number of diabetes-associated deaths will be 622,000 by the year 2025.

That would easily surpass the estimate 440,000 deaths a year attributed to smoking.

In developing countries, people worry about blindness from insect bites. The Yale report estimates that blindness from diabetes will nearly triple in the United States from 24,000 to 70,000 by 2025. Cases of kidney disease will nearly triple from 41,000 to 119,000. We often lament the amputees in civil wars abroad. Amputations caused by diabetes will triple in the United States from 82,000 to 239,000.

The medical costs and loss of work productivity associated with diabetes will also nearly triple, from its current $132 billion a year to $351 billion a year.

We are part of a new global outbreak. While avian bird flu and AIDS are certainly important for international summits, the World Health Organization and the International Diabetes Federation also warn that the number of people worldwide who have diabetes has exploded from 30 million in 1985 to 135 million in 1995 to 194 million in 2003. Unless things change, the number of people with diabetes will reach 333 million, 11 times the number of 1985.

With the proliferation of trash food and declines of physical activity around the world, no nation, regardless of wealth, is immune to this deadly outbreak. The number of people in China with diabetes may grown from 35 million today to between 80 million and 100 million in just the next four years. The number of people in Vietnam with the disease may double to 5 million by 2025. Diabetes is the fastest rising non-communicable disease in Kenya.

In India, lack of access to medical care has resulted in one out of every five diabetics receiving an amputation, compared to one in 13 in Germany. The number of diabetics in India is also expected to double, from 35 million today to 73 million by 2025. Pakistan and Japan are also considered hotspots for diabetes.

It appears that the United States has outsourced more than customer service call centers to places like India. News stories from India have public health officials railing against diets pushed by Western soda and snack companies and fast-food restaurants.

India once was a nation stereotyped as being a land of emaciation.

Today, 17 percent of children in the capital of New Delhi are overweight and obese as two-thirds of youth prefer hamburgers, pizza, and french fries to green vegetables, according to the Delhi Diabetes Research Centre. The research center also found that only 8 percent of children spend an hour a day in physical activity while 42 percent spend an hour watching television or playing computer games. Only 25 percent of children say they spend an hour doing anything outdoors. At least 81 percent of children go to a fast food joint at least once a week.

"Even the children who are not overweight achieve their model weight not because of being active or being healthy, but more because of dieting and eating poorly," said Dr. Ashok Jhingan, the chairman of the Delhi Diabetes Research Centre.

Jhingan echoed what many health experts in the United States have been arguing now for a decade. "The changing obesity epidemic is likely to make diabetes prevalence even higher. So we've recommended that schools and parents should encourage children to play games and limit junk food intake." Jhingan said, "The twin epidemic of obesity and diabetes already represent the biggest public health challenge of the 21st century."

In one city the center studied, Chennai, the prevalence of diabetes has more than tripled in just the last two decades, from 5.2 percent to an estimated 17.4 percent. The challenge is so global and so potentially devastating that the time is coming for communities and governments to view soda and trash food companies as dimly as Philip Morris. Just like in the United States, many families abroad see McDonald's, KFC, and Coke as treats, only to see them -- and television and video games -- become deadly addictions.

Derrick Z. Jackson's e-mail address is jackson@globe.com.

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